Imaging of the pediatric cardiovascular system

Magnetic resonance imaging has become increasingly useful in the assessment of pediatric congenital heart disease. Spin-echo, gradient-echo, and cine techniques allow for both anatomic and functional cardiac assessment. MR imaging has proven most valuable in assessing complex heart disease and in visualizing areas that are sometimes poorly seen on echocardiographic studies. In particular, the anatomy of the aorta, central pulmonary arteries, and veins are usually well defined on MR imaging. Duplex and color Doppler sonography have become indispensable for evaluating the major vessels of the abdomen. The presence of clot, and quantity and quality of vascular flow as well as changes over time and response to therapy are readily assessed. Pulmonary sequestration is just one example of the burgeoning utility of duplex and color Doppler sonography in evaluating abdominal, mediastinal, and juxta-diaphragmatic masses. Sonography shows promise as a simple and accurate method for rapidly identifying the aberrant systemic blood supply in suspected cases of sequestered lung.